Stress and cancer: Is there a connection?

Studies suggest that chemical changes in the body induced by stress may increase the risk of conditions like heart disease and diabetes and the growth and spread of cancer.

Stress is unavoidable. We don’t only have personal stressors, like family and financial responsibilities, to navigate. Thanks to the internet and the 24/7 news cycle, we also have global ones, like the COVID-19 pandemic and conflicts abroad and political turmoil at home.

Over the past three decades, the number of people in America who say they’re stressed has been steadily rising. Today, 49 percent of Americans, report frequently experiencing stress. That’s up 16 percentage points over the past two decades and the highest to date since Gallup started polling.

With stress receiving notoriety in the press for its impacts on mental and physical health, you may worry it may lead to illness or disease, such as cancer. Or, if you have cancer already, you may wonder if stress may make it worse.

In this article, we’ll explore:

If you’ve been diagnosed with cancer and are interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.

Can stress cause cancer?

For decades, research has established that chronic stress—from sources like family tensions or financial worries—causes chemical changes in the body, which contribute to problems like high blood pressure, the release of certain hormones and inflammation. Some studies suggest these stress-induced changes may increase the risk of conditions like heart disease and diabetes—and the growth and spread of cancer.

“In terms of the chronic stressors of modern Western life, whether it's my boss, money or just feeling stressed out, it may have repercussions that have to do with hypertension, heart disease, chronic pain and other conditions,” says Daniel Bruetman, MD, Medical Oncologist at City of Hope® Cancer Center Downtown Chicago.

But can it cause cancer? The findings are inconclusive. And the message that stress increases cancer risk may elicit guilt in patients who are already dealing with their disease.

“They may feel that if they had endured ‘less stress,’ they wouldn’t have gotten cancer, or the treatments would have worked,” Dr. Bruetman says. The National Cancer Institute (NCI) says the link between cancer and stress “is not clear” and that studies on the topic “have had varying results.” If there is a connection, it may be indirect, NCI suggests. Stress may lead to unhealthy habits, such as smoking, drinking alcohol to excess or binge eating, which may contribute to cancer risk.

Stress and inflammation

Researchers today consider inflammation a hallmark of cancer, with up to 20 percent of cancer-related deaths linked to it. And there is evidence that stress can activate an inflammatory response in the brain, as well as in the body.

Stress puts the body on alert. The fight-or-flight response gives your body a burst of energy to face what it perceives as an immediate danger. That can lead to a spike in your heart rate and blood pressure.

“If I'm crossing the street and I see a truck coming at me that's not stopping, I better get stressed out to save my life,” Dr. Bruetman says. “It creates the flight response needed so we can quickly make a run for it.”

Normally, when the danger passes, the response turns off and your heart rate and blood pressure return to normal levels. Sometimes, though—due to factors like long-lasting high stress levels or slight differences in genes—the fight or flight response doesn’t turn off. That may cause inflammation. And chronic inflammation is linked to a host of physical problems, including heart disease and stroke, a weakened immune system and, of course, cancer.

Can stress make cancer worse?

People with cancer not only have to contend with the stresses of everyday life, but also worries associated with their diagnosis, the challenges of treatment and fear of cancer recurrence. They also may worry that the stress they feel may cause their cancer to grow or spread.

It’s true that when you’re in a constant state of stress and your fight or flight system won’t shut off, the body’s inflammatory response may become chronic, too, which may lead to cancer growth or spread. That’s why people with chronic inflammatory bowel disorders like Crohn’s disease and ulcerative colitis tend to have chronic inflammation, for example, and are at a higher risk for colorectal cancer.

There are also studies linking stress to tumor growth in patients who already have cancer. And a newly published study points to biological changes that explain how stress may help a tumor to spread, or metastasize, elsewhere in the body.

In addition to the potential physical dangers, stress may also harm your mental health. If you’re under a lot of stress, you may not be able to make treatment decisions as effectively, says Diane Schaab, MS, LPC, Behavioral Health Therapist at City of Hope Cancer Center Atlanta. And it may impact your sleep.

Stress also may harm your ability to focus on your health and healing.

“A patient may experience a vast number of stressors when they’re diagnosed with cancer, like financial stressors, work and family,” Schaab says. “These stressors may make managing the disease and treatment more difficult than it already is.”

Tips to reduce stress

While everyone may experience stress, not everyone experiences it in the same way. Similarly, different stress relief activities may work for different people. What’s important is finding what works for you.

Schaab’s goal is to help patients learn how to best manage their stressors. She often recommends mind-body exercises—like therapeutic breathing, guided imagery, meditation  and muscle relaxation techniques—to help lower the heart rate and blood pressure and induce a sense of calm.

“It’s shifting the mindset to understanding that you may not be able to change the situation, but you can change how you think about it,” Schaab says.

She also recommends patients set daily goals for themselves as a way to stay focused on the present.

“I love when people set a mind, body and spirit goal for their day,” she says. “It helps them tune into how they can contribute to their well-being and reduce their stress. But we encourage them to write their goals in pencil, versus pen. That way they can adapt based on how their body feels that day.”

Here are some other tips for relieving stress:

  • Accept help
  • Disconnect from electronics
  • Eat healthy
  • Exercise regularly
  • Find a hobby
  • Join a support group
  • Keep a journal to chart sources of stress
  • Listen to music
  • Practice yoga
  • Read a book
  • Take a bath
  • Take a deep breath

Still, Dr. Bruetman says, it’s important to remember that, while exercise, mediation and other stress-relieving practices can help, “no one is cured of cancer because they became less stressed.”

If you’ve been diagnosed with cancer and are interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.